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Page 157 Millien et al. One Health Implement Res 2023;3:148-60 https://dx.doi.org/10.20517/ohir.2023.37

Table 2. Human exposures to rabies suspect animals by case status and species, Haiti January 2013 - December 2017 [9,23]
Total human Human exposures Human exposures Human exposures to Human exposures to
Case exposures to dogs to cats livestock other animals
status
n % n % n % n % n %
Confirmed 222 2.4 217 2.4 2 1.0 3 3.9 - 0.0
Probable 455 4.9 412 4.6 27 13.0 16 21.1 - 0.0
Suspect 1,666 17.8 1,626 18 30 14.4 4 5.3 6 24.0
Non-case 6,969 74.6 6,748 74.7 149 71.6 53 69.7 19 76.0
Not 30 0.3 30 0.3 - 0.0 - 0.0 - 0.0
classified
Total 9,342 100 9,033 100 208 100 76 100 25 100.0

[23]
2017 during which 4,342 cases were reported . For the other years, the field veterinary activities have
decreased, but important efforts have been made by both Ministries of Agriculture and Public Health with
the cooperation of PAHO to maintain the One Health approach to control rabies [Figure 3] .
[23]

More than 26,232 cases of aggression have been notified in Haiti from 2017 until the 7th week of the year
2023. On average, the MSPP can estimates about 4,300 cases of aggression by animals suspected of rabies in
[24]
Haiti per year [Figure 3] .

In 2017, there was one human case of rabies from a dog. In 2021, four cases and two in 2023 (7th week)
[24]
[Figure 4] .
DISCUSSION
HARSP has significantly improved the ability to detect rabies, leading to a substantial increase in reported
animals each month compared to detection rates prior to the effective implementation of HARSP . This
[9]
large increase was the result of the continuous training that the investigating veterinary officers and
technicians received. This increase is also dependent on the increased awareness of the community and
health institutions in relation to the problem of rabies and the geographical extension of HARSP, which has
increased from one to five departments.

The climate of violence over the past three years in Haiti has considerably limited the movement of
veterinary and health professionals in the country. This bad situation did not prevent the two ministries
(Agriculture and Public Health) from continuing to develop a certain number of activities according to the
One Health approach with the support of PAHO. During the period 2017-2023), it is important to show (i)
the number of cases of aggression by animals suspected of rabies by department in Haiti [Figure 3]; (ii) the
trends of human rabies in the country [Figure 4]; and (iii) the celebration of World Rabies Day in
September 2022 by MSPP with the participation of MARNDR [Supplementary Materials]. Several
departments had very limited reports of animal notification, such as the departments of North-East, South-
East, and Grand-Anse, which in 2017 still reported less than 10 rabies surveys. In 2023, that is the same
situation with these departments because of a lack of human resources. These departments still have not
carried out very extensive surveillance to form hypotheses regarding the level of endemicity of rabies, but it
must be assumed that they are also affected. Almost all of the confirmed and probable rabies cases were
dogs, which is consistent with the assertion that dogs are the reservoir of rabies in Haiti. The HARSP is
designed to study animals involved in a human exposure event, both to remove rabid animals from
communities and to provide exposed individuals with evidence-based post-exposure treatment
recommendations [9,18] .